Percepción del uso del humor por parte de enfermeras y pacientes en los servicios de salud mental / Perception of the use of humour by nurses and patients at Mental Health Units

Objetivo: conocer, en función de la literatura disponible, el significado del sentido del humor entre enfermeras y pacientes en el contexto de servicios de salud mental, así como determinar los factores que facilitan o dificultan el uso del sentido del humor en las unidades de salud mental. Métodos: se llevó a cabo una revisión narrativa en el periodo 2022-2023. Las búsquedas se realizaron en Pubmed, PsycINFO, LILACS y CINAHL, usando los descriptores: “Nurse-patient relations”, “mental health”, “wit and humor as topic”, "psychiatric nursing”. Se incluyeron todo tipo de documentos que abordaran el tema según los objetivos, publicados desde 2012 hasta noviembre de 2022 en inglés, español o portugués. Se añadió un artículo traducido del coreano por su relevancia. Resultados: se incluyeron 10 manuscritos en la revisión. Los hallazgos sugieren que el sentido del humor se percibe como una herramienta esencial para fortalecer la relación entre enfermeras y pacientes en entornos psiquiátricos. No obstante, se destaca la existencia de factores que podrían conducir a un uso inapropiado del humor, llevando a la deshumanización de la atención y la posible ruptura del vínculo terapéutico. Conclusiones: es importante considerar cuidadosamente el empleo del humor en el contexto de la salud mental, para garantizar su efectividad sin comprometer la calidad asistencial. (AU)

Objective: based on the literature available, to understand the meaning of sense of humour between nurses and patients in the setting of Mental Health Units, as well as to determine the factors that facilitate its use, o make it difficult. Methods: a narrative review was conducted during the 2022-2023 period. Searches were conducted in Pubmed, PsycINFO, LILACS and CINAHL, using the descriptors: “Nurse-patient relations”, “mental health”, “wit and humor as topic”, “psychiatric nursing”. All type of documents addressing this matter according to the objectives were included, published from 2012 until November 2022 in English, Spanish or Portuguese. An article translated from Korean was added due to its relevance. Results: ten (10) manuscripts were included in the review. Findings suggested that sense of humour was perceived as an essential tool in order to strengthen the relations between nurses and patients in psychiatric settings. However, it was highlighted that there are factors which could induce an inadequate use of humour, leading to dehumanization in care and a potential breach in the therapeutic link. Conclusions: it is important to carefully consider the use of humour in the mental health setting, in order to guarantee its effectiveness without compromising the quality of care. (AU)

Análisis de las propiedades psicométricas de un cuestionario para medir la actitud hacia el humor en los profesionales sanitarios / Analysis of the psychometric properties of a questionnaire to measure the attitude towards humor in healthcare professionals

Objetivo principal: Analizar las propiedades psicométricas de un instrumento diseñado específicamente para evaluar la actitud ante el humor en profesionales sanitarios. Métodos: Estudio de validación, transversal. Se determinó la fiabilidad con el índice de discriminación, el coeficiente de correlación intraclase e ítem-total, el α de Cronbach y el índice de Pearson. La validez de constructo se analizó con el análisis factorial exploratorio. Resultados principales: La Escala Multidimensional del Humor en Profesionales Sanitarios (EMHUPS) consta de 35 ítems y 8 factores: humor con el paciente, en el trabajo, en los cuidados, en el entorno privado, formación en humor, en el entorno sanitario, demanda de formación en humor y humor y ocio. Presenta una varianza del 60,99% y una fiabilidad de 0,88. Conclusión principal: La escala EMHUPS presenta unas propiedades psicométricas aceptables en la medida del humor en profesionales sanitarios. (AU)

Objective: To evaluate the psychometric properties of an instrument designed specifically designed to determine attitude towards humor in health professionals. Methods: A cross-sectional and a validation study. The reliability study analysed the discrimination capacity of the items with discrimination index, the intraclass and item-total correlation coefficient, the Cronbach's α coefficient and the Pearson's correlation coefficient. In the validation study, the Exploratory Factor Analysis was carried out. Results: The Multidimensional Scale of Humor in Healthcare Professionals (EMHUPS) consists of 35 items divided into 8 factors: humor with the patient, humor at work, humor and care, humor in the private environment, training in humor, humor and the sanitary environment, demand for training in humor and humor and leisure. These factors explained a total variance of 60.99% with overall reliability of 0.88. Conclusions: EMHUPS presents acceptable psychometric properties in the measurement of humor in healthcare professionals. (AU)

Diseño de un instrumento de medida del humor en profesionales sanitarios / Design of an instrument to measure humor in health professionals

Objetivo: Diseñar un instrumento de medida del humor en los profesionales sanitarios. Método: Estudio descriptivo, observacional y transversal de metodología mixta. Se elaboró el instrumento en varias fases: revisión bibliográfica, generación de los ítems, determinación del formato, evaluación por panel de expertos, estudio piloto, reevaluación por panel de expertos y test-retest. Se analizó la pertinencia, la relevancia y el grado de comprensión de los ítems. Se calculó la validez interobservador con el índice kappa y el coeficiente de correlación intraclase, considerándose los valores ≥ 0,61. Se utilizó la t de Student para muestras relacionadas y el coeficiente de correlación de Pearson. Para todas las pruebas se aceptó un valor de p<0,05. Resultados: La Escala Tridimensional del Humor en Profesionales Sanitarios consta de 50 ítems medidos con una escala Likert de 5 puntos en función del grado de acuerdo. El panel de expertos valoró la escala global con 3,57 (0,79) puntos sobre 5. Se obtuvo una fiabilidad interobservador de 0,69 (p<0,001) en el estudio piloto, un coeficiente de correlación de Pearson de 0,71 (p=0,002) y un coeficiente de correlación intraclase de 0,69 (p=0,001) en el test-retest. No se observaron diferencias estadísticamente significativas entre las puntuaciones del test-retest. Conclusión: La Escala Tridimensional del Humor en los Profesionales Sanitarios es una herramienta innovadora en la medida del humor en el contexto sanitario, creada específicamente para profesionales sanitarios. Antes de su utilización, es necesario analizar su validez y fiabilidad en futuros estudios.(AU)

Aim: The objective of this study was to develop an instrument for measuring humor in health professionals. Methods: Observational, transversal and descriptive study of mixed methodology. The instrument was designed in several phases: literature review, item generation, determination of the scale format, review by the expert panel, pilot study, reevaluation by the expert panel, and test-retest. The pertinence, relevance and comprehension of the items were analyzed. Interobserver agreement was calculated with Kappa and the intraclass correlation coefficient considering values ≥ 0.61. Pared sample Student's t test and Pearson's correlation coefficient were used. A level of statistical significance was established at P<0,05. Results: The Three-Dimensional Scale of Humor in Health Professionals consists of 50 items measured with a 5-point Likert scale based on the degree of agreement. Experts’ panel evaluated the global scale with 3.57 (0.79) points out of 5. An interobserver reliability of 0.69 (P<0.001) was obtained in the pilot study. A Pearson correlation coefficient of 0.71 (P=0.002) and an intraclass correlation coefficient of 0.69 (P=0.001) resulted in the test-retest. No statistically significant differences were observed between test-retest scores. Conclusion: The Three-Dimensional Scale of Humor in Health Professionals is an innovative tool for measuring humor in the health context. This scale is created specifically for health professionals. It́s necessary its validation in future studies.(AU)

Design of an instrument to measure humor in health professionals.

AIM: The objective of this study was to develop an instrument for measuring humor in health professionals. METHODS: Observational, transversal and descriptive study of mixed methodology. The instrument was designed in several phases: literature review, item generation, determination of the scale format, review by the expert panel, pilot study, reevaluation by the expert panel, and test-retest. The pertinence, relevance and comprehension of the items were analyzed. Interobserver agreement was calculated with Kappa and the intraclass correlation coefficient considering values ≥0.61. Pared sample Student's t test and Pearson's correlation coefficient were used. A level of statistical significance was established at P < 0.05. RESULTS: The Three-Dimensional Scale of Humor in Health Professionals consists of 50 items measured with a 5-point Likert scale based on the degree of agreement. Experts' panel evaluated the global scale with 3.57 (0.79) points out of 5. An interobserver reliability of 0.69 (P < 0.001) was obtained in the pilot study. A Pearson correlation coefficient of 0.71 (P = 0.002) and an intraclass correlation coefficient of 0.69 (P = 0.001) resulted in the test-retest. No statistically significant differences were observed between test-retest scores. CONCLUSION: The Three-Dimensional Scale of Humor in Health Professionals is an innovative tool for measuring humor in the health context. This scale is created specifically for health professionals. It's necessary its validation in future studies.

Validation of the humour styles questionnaire in healthcare professionals.

AIM: The aim of this study is to determine the reliability and validity of the Humour Styles Questionnaire (HSQ) in a sample of Spanish healthcare professionals. DESIGN: A cross-sectional study. METHODS: The version of HSQ translated into Spanish by Cayssials and Pérez was used to validate on a sample of healthcare professionals (N = 250). The reliability analysed the Crombach's α coefficient and Pearson's correlation coefficient between the factors and the total scale score. The Exploratory Factor Analysis was carried out with Kaiser's criteria for the extraction of factors with Varimax rotation. RESULTS: HSQ in this study sample reproduced the similar structure of the original version with four factors (affiliative, self-enhancing, aggressive and self-defeating humour). These factors explained 44.46% of the total variance and Cronbach's ranged from 0.64-0.79. Global HSQ scale reliability was 0.82. CONCLUSION: The HSQ is a valid and reliable instrument for assessing humour in healthcare professionals.

Nutritional intervention in patients with heart failure. 3 month results of a clinical trial / Intervención nutricional en pacientes con insuficiencia cardíaca 3 meses después de los resultados de un ensayo clínico

Background: A variety of studies have detailed the "paradox of patients with obesity and heart failure". There exists a reverse epidemiology: obesity predisposes the development of cardiovascular diseases and heart failure, but a high body mass index improves survivability at two and at five years. Subsequently, other studies have been shifting this focus not with the body mass index, but instead with the nutritional status and unplanned weight loss. It is not clear the role of the nutritional treatment in these patients. Aims: Evaluation of 2-part intervention (dietary recommendations + supplements) over the nutritional status, quality of life and functional capacity in heart failure patients who exhibit malnutrition or the risk thereof after 3 months treatment. Methods: A sample of 76 chronic heart failure patients who exhibit malnutrition or the risk thereof participated in a clinical trial on an intention-to-treat basis. The intervention group received structured recommendations combined with dietary supplements for 12 weeks and control group received the standard intervention. Assessors were blinded. The nutritional status was measured with Subjective Global Assessment (SGA), QOL with Minnesota Living with Heart Failure Questionnaire and functional capacity with the 6- minute walk test. Results: At three months, the intervention group improved four times the nutritional status measured with SGA. The control group remained similar. The intervention group improved in the same variables as the control group (except in mean total proteins) and also improved in parameters associated with energy reserves (triceps skin fold, mid-upper arm fat area and cholesterol). Conclusion: Nutritional counseling, accompanied by normoproteic hypercaloric supplements, in patients with chronic heart failure, treated with ACEI / ARA II or beta-blockers, can improve the nutritional status at three months

Antecedentes: Una variedad de estudios han detallado la "paradoja de pacientes con obesidad e insuficiencia cardíaca ". Existe un epidemiología inversa: la obesidad predispone al desarrollo de las enfermedades cardiovasculares y la insuficiencia cardíaca, pero un cuerpo con alto IMC mejora la supervivencia a los dos años y a los cinco años. Posteriormente, otros estudios han ido cambiando este enfoque no con el índice de masa corporal, sino con el estado nutricional y la pérdida de peso no planificada. No está claro el papel del tratamiento nutricional en estos pacientes. Objetivos: Evaluación de la intervención en 2 partes (recomendaciones dietéticas + suplementos) sobre el estado nutricional, calidad de vida y capacidad funcional en pacientes con insuficiencia cardíaca, quienes presentan desnutrición o riesgo de sufrirla después de 3 meses de tratamiento. Métodos: muestra de 76 pacientes con insuficiencia cardíaca crónica que presenten malnutrición o riesgo. El grupo de intervención recibió recomendaciones estructuradas combinadas con Suplementos dietéticos durante 12 semanas y el grupo control recibió la intervención estándar. Los asesores fueron cegados. El estado de nutrición se midió con l Evaluación Global Subjetiva (SGA), la calidad de vida con Minnesota Living with Heart y la capacidad funcional con la prueba de la caminata en 6 minutos. Resultados: A los tres meses, el grupo de intervención mejoró por cuatro veces el estado nutricional medido con SGA. El grupo control se mantuvo similar. El grupo de intervención mejoró en las mismas variables que el grupo de control (excepto en la media total proteínas) y también mejoró en los parámetros asociados con reservas de energía (pliegues de la piel del tríceps, área de la parte media de la grasa del brazo y colesterol). Conclusión: el asesoramiento nutricional, acompañado de dieta normoproteica, y suplementos hipercalóricos, en pacientes con enfermedades crónicas de insuficiencia cardíaca, tratada con ACEI / ARA II o bloqueadores beta, puede mejorar el estado nutricional a los tres meses